Why the study?
Patients with cirrhosis face increased peri-operative mortality risk, but the impact of surgical procedure category on this risk is poorly understood.
Does surgical procedure category affect in-hospital mortality in patients with cirrhosis?
Does surgical procedure category affect in-hospital mortality in patients with cirrhosis?
In patients with cirrhosis, in-hospital mortality varies significantly by surgical procedure type, with major abdominal and cardiovascular surgeries carrying higher risk than orthopedic surgeries.
Answers are grounded in this paper and cite their sources.
May guide perioperative risk discussions in cirrhosis; hypothesis-generating and requires prospective validation.
BACKGROUND: Patients with cirrhosis have increased peri-operative mortality risk relative to non-cirrhotic patients, however, the impact of surgical procedure category on this risk is poorly understood. METHODS: We performed a retrospective cohort study of cirrhosis surgery admissions using the National Inpatient Sample between 2012 and 2014 to estimate the adjusted odds of in-hospital mortality by surgical procedure category. RESULTS: In-hospital mortality differed by surgical procedure category. Relative to major orthopedic surgeries, major abdominal surgeries had the highest odds of in-hospital mortality (odds ratio [OR] 8.27, 95% confidence interval [CI] 5.96-11.49), followed by major cardiovascular surgeries (OR 3.45, 95% CI 2.33-5.09). There was also a significant interaction term, whereby elective/non-elective admission status impacted in-hospital mortality risk differently for each surgical procedure category (P < 0.001). CONCLUSION: In-hospital mortality varies substantially by surgical procedure type. Accounting for procedure type in models may improve risk prediction for peri-operative mortality in patients with cirrhosis.
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Mahmud et al. (2019) studied this question.
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